Learning Disabilities/Developmental Delay 
Learning disability is a term that describes specific kinds of learning problems. Learning disabilities can cause a person to have trouble learning and using certain skills. Common learning disabilities are disorders of reading, written expression, math, and auditory or visual processing issues.
According to the National Center for Learning Disabilities, currently 2.4 million students are diagnosed with learning disabilities and should receive special education services in their schools. 67% of students with learning disabilities graduate from high school with a regular diploma. 20% of students with learning disabilities drop out of high school. Identification and early intervention can help improve those outcomes.
Experts look for how well a child is doing in school, or the potential of how well the child can do. Psychoeducational evaluations and neuropsychology evaluations may help determine if the child has a learning disability. Referrals can be made for children to undergo Neuropsychological Testing, which seeks to determine a child’s level of cognitive function, memory, language skills, visual spatial function, planning, problem solving, and organizational skills in order to assess for learning strengths and difficulties. Proper assessment of areas of difficulties are key to help parents, educators, therapists, and the child work toward developing the most appropriate treatment plan. Dr. Kothari who practices in the Boca Raton, Delray Beach, Parkland, Coral Springs and South Florida area refers patients for further testing as needed to psychologists who are experienced in assessing learning disabilities and educational delays. She also frequently reviews reports which may be very helpful for her to further understand a child’s areas of strengths and weaknesses.
Intellectual Disability
Formerly called mental retardation, intellectual disability refers to significantly impaired intellectual and adaptive functioning. It is defined by an IQ of less than 70, deficits in two or more areas of adaptive behaviors that affect everyday life, and evidence that the limitations manifested during childhood or adolescence. About 2-3% of people have an intellectual disability, with 75-90% of those people having a mild form of disability. Most people with an intellectual disability do not physically appear different, however most may exhibit some or all of the following symptoms: language delays, deficits in memory, difficulty learning social rules, difficulty with problem solving, delays in self care skills, and lack of social inhibitors. The causes of intellectual disabilities is unknown for up to one half of all cases. Some known causes are genetic syndromes, difficulties during pregnancy or childbirth, exposure to diseases or toxins, and malnutrition.
An appropriate diagnosis is crucial, as is early intervention. With early intervention, therapy, support, and persistence many children with intellectual disabilities can become productive members of the community. Support for the family, in addition to the child, may be integral in a successful outcome. Dr. Kothari can make referrals for local support groups and to psychologists for family counseling as well as further medical and neurological workups as needed.
Genetic Syndromes
Genetic syndromes are conditions that are due to a defect in DNA that causes abnormal growth or development. Genetic syndromes may be inherited or may occur spontaneously. A child with a genetic syndrome may appear normal at birth and begin to display signs of the genetic syndrome after birth, and often when the child begins to feed and grow. Examples of genetic syndromes are Down Syndrome, Fragile X, Prader-Willi, Rett syndrome, and Angelman syndrome. Often, children with genetic syndromes experience learning and language delays, intellectual disabilities, fine motor delays, as well as a variety of other symptoms.
A child psychiatrist may help children with a genetic syndrome with further evaluation for any emotional or learning needs. A psychiatrist may also assist their family with counseling and offer referrals to local support groups or psychologists.
Speech Language Delay
Speech and language disorder refers to abnormal language development. It is the most common developmental problem and affects 5 to 10% of preschool age children. It can be difficult to know whether a child is a “late bloomer” or if they have an expressive language disorder or another underlying cause of speech delay. Early identification of the problem is crucial to understanding the cause of the delay and how best to treat it. Some causes may include hearing difficulties, learning disabilities, intellectual disabilities, prematurity, auditory processing disorder, apraxia, autism, and selective mutism.
Treatment for speech language delays should be individualized to each child’s needs. Often a team of health professionals including a doctor, speech language pathologist, audiologist, social worker, and a occupational therapist will work together to develop and implement a treatment plan. A child psychiatrist or child psychologist may be called in to assist with the treatment plan in certain cases, including selective mutism, autism, and when the delay is causing undue anxiety or depression.
Fine Motor Delay
Children develop a myriad of fine motor skills over the course of their growth and development. These skills allow them to make small movements with their finger, hands, and, toes. Children with delays in fine motor development appear to have diminished hand-eye coordination and can appear clumsy. They may have trouble with or avoid drawing, writing, scribbling on paper, using scissors, building with blocks, or eating meals with a utensil.
Early identification and treatment of fine motor delays are crucial to successful. Treatment usually involves a doctor, occupational therapist, educator, and possibly a neurologist or other specialist. For some children with fine motor delays, especially those with autism and ADHD, a child psychiatrist may be part of the treatment team.
Bedwetting
Bedwetting is a normal occurrence in childhood. But as the child gets older, recurrent bedwetting may cause shame, embarrassment, low self esteem, may limit social development, and cause rashes. For some children, bedwetting may be a symptom of an underlying medical condition that requires medical attention. When a pediatrician has ruled out medical causes and parents have instituted day and night time routines to eliminate the bedwetting, emotional causes may be explored. If a child is exhibiting changes in mood, irritability, persistent sadness, or a change in sleep habits, a child psychiatrist may be called in to evaluate the child for physical and/or emotional problems that may be causing the bedwetting, and help resolve the issue.
